Results Of the patients 95.6% had diagnoses appropriate for OOHM. Most presentations required assessment by a clinician with skills in assessing illness (39.6%) or injuries (30.9%). One thousand two hundred and ninety-one (42.75%) required no investigations and 1007 (33.3%) were provided only with reassurance. Of the presentations 42.2% were judged to have been totally avoidable if the family had had better health education.

Of the patients 26.1% were judged appropriate for current primary care (community pharmacy or general practice) with 31.5% appropriate for the combination of enhanced general practice and community pharmacy. Proportions suitable for new models were 14.1% for the nurse-led acute illness team, MCP 25.7%, GP federation CYP service 44.6%, comprehensive walk-in centre for CYP 64.3% and 75.5% for a PACS.

Conclusions High proportions of ED presentations by CYP could potentially be managed in new OOHMs or by enhancement of existing primary care.

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Footnotes

Handling editor Martin Ward Platt

Contributors The study was conceived and designed by RMV, TP, FB and RM. CL, AR, MW, FC and DSH helped to refine the design. FB, FW, SN and TP organised and undertook data collection. RMV led the analyses, with input from FB and FW. RMV led the writing of the paper, with input from DSH, FW, TP and MH. All authors approved the final version of the paper.

Funding Funding for this study was provided by the Children and Young People’s Board of Healthy London Partnerships, a transformation programme jointly funded and administered by NHS England (London Region) and the London Board of CCGs.

Data sharing statement Data are available upon request to the first author, RMV.

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